The City Bridge Trust
Charity Registration Number: 1035628
Monitoring & Evaluation Form
Working with Londoners (Grants of £10,000+)
Name of Organisation in receipt of grant:Bishop Creighton House / Grant Reference:
11230
Name & position of person completing form:
Joy Houghton-Brown / Contact Tel No/E-mail:
0207 385 9689
.org.org
Original purpose of grant: £122,500 over three years (£40,250; £40,750; £41,500) for a full-time Volunteer Co-ordinator plus management and other costs of the Keep Active project.
1. / Has the grant payment for the year been used in full?
YES
2. / If not, please explain why this is the case and when it is expected to be fully used:3. / Please provide the period of the grant awarded by the Trust. If the grant is/was for more than one year, please complete the relevant boxes below:
Year 1 / Year 2 / Year 3
FROM / month / year / month / year / month / year
4 / 2013 / 4 / 2014 / 4 / 2015
TO / month / year / month / year / month / year
3 / 2014 / 3 / 2015 / 3 / 2016
4. / If your grant includes staffing costs, please confirm the name(s) of the postholder(s) and their start date: Miriam Baines 8.4.2013
5. / Have you provided a copy of your most recent Annual Report, acknowledging support from the Trust, together with Audited Accounts covering the period during which the grant was used?
Annual Report: No
Audited Accounts: No
6. / If not, when will these be available?
Annual Report: October 2014
Audited Accounts: October 2014
7. / What were the key objectives of the work funded by the Trust?
1. To support isolated older and disabled people to get active and independent again after a fall or illness.
2. To recruit, train and support a team of volunteers to provide one-to-one encouragement and help in walking outside and exercising.
3. To work alongside staff in the Community Rehabilitation Service, complementing their professional care.
4. To create a working model for community health support, which could be replicated in other neighbourhoods.
8. / Have you received any training in monitoring and evaluation?
YES
If yes, who provided the training? Hammersmith and Fulham Community and Voluntary Sector Association (CAVSA): 19 April 2013
9. / Please tell us how you have met your objectives.
· Use the monitoring information you have been collecting to describe the project’s outputs* and outcomes* making it clear you know how you have achieved your outcomes.
* ‘Outputs’ are the quantifiable activities that your project has carried out in order to meet its objectives.
* ‘Outcomes’ describe the effects or impact of your project and the difference you have made to those with whom you have worked.
Your monitoring statistics and service user feed-back should help provide the information you need. If you are unsure about what information you should be collecting, please contact your Grants Officer.
1. Objective: To support isolated older and disabled people to get active and independent again after a fall or illness.
Outputs: 450 people in total (150 people each year over 3 years) supported through a 9 week recovery programme by our volunteer and staff team.
70 clients*, discharged from the Hammersmith & Fulham Community Rehab Service (hereon referred to as CRS), have been referred to the Keep Active Service and have received ongoing support through the Keep Active 9 week recovery programme. Keep Active volunteers have given 622 hours of support to clients.
* This figure is lower than the target of 150 clients given in the funding outputs due to this being a pilot first year, and for the reasons given under Objective 3 below.
Outcome: Improved mobility, physical health and mental wellbeing for older people with a disability or poor health.
· In a follow-up questionnaire, 96% of clients reported feeling healthier and more confident with the exercise programme/goal the CRS had given them following the volunteer support.
· Keep Active achieved this outcome through close partnership working with CRS. Physiotherapists and occupational therapists identified patients that were due to be discharged, but who could benefit from more support with their goals. These clients were questioned before and after the volunteer support to assess the difference the volunteer support had made and how it had impacted their health and confidence.
· There was an increase in health and confidence in 96% of the clients.
· At the beginning of the volunteer support, physiotherapists and occupational therapists graded the client’s ability with the goal set according to a rating from -2 to +2. At the end of the session the clients were graded again and an increase in this score was seen in 91% of cases.
· Additional evidence of wellbeing was shown in that 98% of the clients questioned said they felt happier when their volunteer visited them and 39% of clients were referred onto other support services within their community which gave them further opportunities for social interaction and promoted mental wellbeing.
Please see Appendix 2:Client Stories & Appendix 3: Quotes from Clients
2. Objective: To recruit, train and support a team of volunteers to provide one-to-one encouragement and help in walking outside and exercising.
Outputs: 150 volunteers recruited over three years; Bi-monthly training sessions provided from CRS; Bi-monthly volunteer meetings, quarterly steering group and ongoing support/supervision.
· In the first year we recruited 69 volunteers between the ages of 18 and 75
· 6 Bi-monthly training sessions have been provided by CRS and Keep Active. 69 Volunteers received high quality training by CRS staff (eg, Physiotherapist, Occupational Therapist and Community Rehab Assistant). In addition to this we provided 6 Bishop Creighton House Volunteer Induction training sessions which all 69 volunteers attended so that they were familiar with our policies and procedures relating to good practice, personal safety and home visits. 98% of the volunteers scored the training as ‘excellent’.
· 6 external, specialist training sessions were offered to Keep Active volunteers eg, Heart start training (British Heart Foundation) Alcohol Abuse (H&F Older People’s Alcohol Service) Dealing and Coping with Loss (K&C Cruise)
· 6 Bi-monthly volunteer support meetings/volunteer social events were offered in partnership with Homeline’s volunteer support programme.
· Ongoing support/Supervision: 35 support and supervision sessions were given to volunteers by Keep Active staff during the process of monitoring the outcomes of our 9 week interventions. At these meetings volunteers talked through what went well, any difficulties and their future plans.
· Quarterly steering group: Keep Active staff met with CRS on a quarterly basis and 5 meetings have taken place. The next scheduled meeting (April 2014) will also be attended by a client and volunteer.
Outcome: Local people of all ages provided with a rewarding and meaningful volunteering experience, with training and support from physiotherapists.
· Volunteers received high quality training by Keep Active staff as well as CRS staff (eg, Physiotherapist, Occupational Therapist and Community Rehab Assistant).
· After interview, the volunteers were matched with clients. The volunteers’ and clients’ interests and hobbies were taken into account and individuals were matched accordingly to increase the chances that their volunteer experience would be rewarding and meaningful.
· Volunteers were made aware that any queries or problems that immerged during their visits with the clients could be fed back to staff at Keep Active who in turn raised this with the physiotherapist or occupational therapist who referred the client.
· Keep Active staff liaised between the volunteer and therapist ensuring that the volunteer felt that they could get support and advice from the Rehab team once they were doing the home visits on their own.
· As a consequence of their excellent volunteering with Keep Active one volunteer has now been offered a permanent Rehab Assistant post with Hammersmith & Fulham CRS.
Please see Appendix 4: (Quotes from Volunteers) for quotes from volunteers over the first year of Keep Active.
3. Objective: To work alongside staff in the Community Rehabilitation Service, complementing their professional care.
Outputs: 450 ongoing cases (150 per year) from the community rehabilitation service discharged (into Keep Active)
In Year One Referrals have been coming from Community Independence Reablement Service (CIS) , Community Rehab Unit (CRU)(Bedded High Dependency patients) and Community Rehab Service (CRS)
In year One a total of 70 patients* were discharged into the Keep Active Service. The breakdown of referrals was as follows:
CRU: 0
CIS: 6
CRS: 64
*Reasons for Keep Active referrals being lower (i.e. 70 not 150 per year):
CRU:
· Although wanting to refer into Keep Active we have actually received no referrals from CRU to date due to much higher dependency of patients who would often returning home with significant packages of care and needs not suited to Keep Active volunteers.
· Major staffing issues with many posts filled by short-term ‘locum’ staff unfamiliar with Keep Active.
· CRU will remain a potential source for a low number of referrals.
CIS:
· Major staffing issues with key staff having left during the year and replaced currently by locum staff who have now also moved on.
· Understaffing and high waiting lists have meant CIS only focusing with short term cases.
· CIS take full responsibility for the low rate of referrals: Sarah Teague, Clinical Lead: falls and bone health (CLCH NHS TRUST) ”CIS hashad tonarrow their inclusion criteria temporarily to see only urgent 'rapid response' referrals not requiring rehabilitation work” March 2014
CRS:
· Major restructuring of staff meaning vacancies within the team, backfill by agency staff and high agency staff turnover leading to loss of knowledge about local services and resources
· CRS team members having less time to induct new staff to the specifics of Keep Active Service nor to ensure a constant stream of referrals wasmaintained.
· Sarah Teague March 2014 quotes “ It is highly likely, due to changes to the structure of CRS as a result of clinical restructure and increased demands on the clinicians as a result of resource limitation, that the 150 referrals per year proposed in the Keep Active Business Case was an over estimation. However, with the vacant posts filled and the leadership of Keep Active within CRS optimised via staff induction and referral monitoring, it is reasonable to expect 100 referrals per year going forward into year 2 of the project.”
Outcome: Reduced pressure and more capacity to concentrate on acute cases for
the Community Rehab Service;
In our recent Steering Group (13/3/2014) with CRS, Senior staff stated that Keep Active had reduced pressure by enabling staff to move their focus to more acute cases. Sarah Teague quoted March 2014 “Early discharge of low need clients where staff felt the Keep Active volunteer could meet the client requirements has freed up staff time for more urgent cases.” CRS are also undertaking running a report to show the average length of treatment (in number of direct contacts) and to show these clients have not been referred back into H&F CRS since discharge from the service
Outcome: Reduced hospital re-admissions following falls or illness.
This data is not currently available (ie for the 2013-14 reporting year) because of information governance legislation preventing the sharing of client level data. However, a new 2014-16 NHS partnership agreement should allow for the sharing of information about clients who have been admitted to hospital and should mean that during year 2 (ie 2014-15 reporting year) Keep Active should be able to demonstrate fewer admissions amongst those referred to Keep Active during intervention period and in the 3-6 months post discharge.
“However (we quote Sarah Teague) It must be acknowledged that admission to hospital may not be a sensitive measure of effectiveness of the Keep active model in consideration of the client group seen by the volunteers i.e. those who are the oldest clients, with multiple long term conditions/diagnosis, frailty and complex needs. An acute admission in this client group (and the prevention of one) will be dictated by many variables over and above Keep Active input e.g. medical deterioration/disease progression.”
• In your application you said you would meet the following outcomes of the Trust:
More over 75's living healthier and more active lives.
Your report should also describe how you met our outcome(s) and how you know you have achieved this.
• Where appropriate, we would like to see a summary of your monitoring statistics and feedback from those with whom you have worked.
How we met your outcome: More over 75's living healthier and more active lives:
· The Keep Active project has enabled 70 older people discharged from CRS, to receive 622 hours of continued support with their goals: indoor exercises, mobility, accessing the community, domestic tasks and communication practice.
· In a follow-up questionnaire, 96% of clients reported feeling healthier and more confident with the exercise programme/goal CRS had given them following the volunteer support.
· Keep Active achieved these outcomes through close partnership working with CRS. Physiotherapists and occupational therapists identified patients due to be discharged, but who they felt could benefit from more support with their goals.
How we know we have achieved this:
· All clients were questioned before and after the volunteer support to access the difference the volunteer support had made and how it had impacted their health and confidence. There was an increase in health and confidence in 96% of the clients.
· At the beginning of the volunteer support, the physiotherapists and occupational therapists graded the client’s ability with the goal set according to a rating from -2 to +2. At the end of the session the clients were graded again and an increase in this score was seen in 91% of cases.
· 98% of the older people questioned after their volunteer support said they felt happier when their volunteer visited them and 39% of clients were referred onto other support services within their community which gave them further opportunities for social interaction and promoted mental wellbeing.
Please see Appendices 3, 4 and 5 for feedback from clients, volunteers and professionals with whom we have worked.